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The Opioid Epidemic: The Oft-Forgotten Elderly

When people think of “drug addiction,” what do they visualize? Is it a teenager who experimented with substances with friends? A 29-year-old female who suffered from childhood abuse and struggles with mental health disorders due to her past? How about a 46-year-old male who has a high-stress job and relies on substance misuse to ease some of his anxieties?

Sure, any person that fits any of these descriptions could, and in many cases do, suffer from drug addiction. There are so many more images of people that routinely pop into people’s minds when they consider the millions of Americans struggle with this illness.

However, there are some forgotten demographics. One in particular stands out: the elderly.

A recent study by The Recovery Village surveyed 400 people regarding their thoughts on drug and alcohol treatment, which age demographic of people is most affected, and other topics related to substance misuse. More than half — 51 percent — of the 400 survey respondents envision a young adult between the ages 20 and 35 as the face of drug addiction. Middle-aged adults between the ages 36 and 55, received 21.25 percent of the answers while teenagers received 14.5 percent.

At the bottom of the results were older adults and seniors, two answers that combined for just 13.25 percent. Seniors, classified as at least 65 years old, received 5.75 percent, the lowest of the five choices.

Addiction is on the rise for the elderly, though, and it’s in America’s best interest to become more aware of and pursue avenues to halt this growing trend.

How Many Elderly Americans are Addicted?

Drug addiction and misuse has been a struggle, not just in the United States but all over the world, for a lot longer than the phrase “opioid epidemic” has been trending in headlines. Yet, when people think of substance use disorders, one of the first images is the rise of opioids and opiates and the increasing prevalence of prescription-drug addiction.

The National Council on Alcoholism and Drug Dependence reports that 2.5 million “older adults” suffer from an addiction to a substance. While people age 65 or older comprise only 13 percent of the U.S. population, they account for nearly 30 percent of prescriptions in the country.

According to an article in the Chicago Tribune, in the past few decades, seniors who suffer from arthritis, cancer, neurological diseases and other illnesses common to old age were prescribed pain medicine more and more frequently. Opioids are prescribed to treat such chronic pain, and the increase in the elderly suffering from the general wear and tear of the body over time has led them to being handed an imperfect “quick-fix” solution to their problems in the form of these addictive painkillers.

A study of Medicare recipients, as cited on the JAMA Internal Medicine website, found that in 2011 around 15 percent of people age 65 and older were prescribed an opioid when they were discharged from the hospital. Three months later, more than 40 percent of those elderly were still relying on the pain medicine to ease their suffering.

Yet, the stigma of the opioid epidemic remains elsewhere, on other age demographics. Why has that happened, and what can be done to shine a helpful light toward the elderly?

Medicare: The Path to Addiction?

The Substance Abuse and Mental Health Services Administration reported in 2017 that opioid misuse among older Americans was significantly higher in 2014 than in 2002. By comparison, opioid misuse among young adults dropped in the same time frame.

But why are the elderly becoming more exposed to substance use disorders?

Around 40 percent of survey respondents said that being prescribed multiple drugs simultaneously is a main reason why seniors develop an addiction. One-third of participants blamed the substance use disorder on chronic pain, and 16.75 percent of respondents answered that co-occurring health problems such as diabetes, dementia and high blood pressure are the main causes for this age demographic’s exposure to addiction.

There might be another cause, though.

Sen. Robert P. Casey Jr., a member of the Senate Special Committee on Aging, was one of the first to tie Medicare to the rising prevalence of opioid misuse among the elderly.

The connection? Medicare often can be used to fund prescriptions, but the government-provided insurance for Americans age 65 and older often does not pay for treatment.

“While Medicare pays for opioid painkillers, Medicare does not pay for drug and alcohol treatment in most instances, nor does it pay for all of the medications that are used to help people in the treatment and recovery process,” William B. Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance, in Harrisburg, Pennsylvania, said at the Senate Special Committee on Aging hearing. “Methadone, specifically, is a medication that is not covered by Medicare to treat opioid use conditions.”

Gary Cantrell is a deputy inspector general at the Department of Health and Human Services and offered some insight about how Medicare can do more harm than good for many elderly. Cantrell told the Washington Post that Medicare Part D beneficiaries have more exposure to opioid prescription painkillers and nearly 500,000 of them received “high amounts of opioids” in 2016, signalling that many of them are at risk of developing an addiction.

Why are We Forgetting the Elderly?

People get old. That’s a fact of life.

With aging comes physical pain and sometimes mental deterioration. Physical pain often can lead to a doctor’s office visit, when a medical professional will deem an opioid prescription as a viable first step in treatment. If someone develops a dependency on the drug, the signs could be mistaken as examples of delirium or dementia. That was one example given by Paul Krupski, director of opioid initiatives for the Wisconsin Department of Health Services, on how society often overlooks the elderly and their potential for addiction.

Krupski also told the Wisconsin State Journal that social isolation is common among the elderly and can deter them from seeking help for their struggles. In doing so, many people simply do not know how prevalent opioid addiction is among older adults.

Survey respondents had a different answer for why seniors are so often overlooked in this discussion. Around 33 percent of participants said that the media has focused on the younger generation when giving a face to the epidemic. A little less than 20 percent of respondents said the medical community has not done a proper job of acknowledging this issue. The other three remaining choices were:

Friends and family members do not recognize their elderly loved one’s addiction (16.75 percent)

Perception of seniors as immune to drug or alcohol addiction (16.75 percent)

Symptoms of addiction often mimic signs of aging (13.75 percent)

When asked to compare seniors and young people, respondents overwhelmingly agreed that recognizing substance use disorders in older people is more difficult. Nearly three-quarters of survey participants said this, and the two overwhelming reasons why were: Many of the symptoms could be attributed to a decline in overall health (41.52 percent); and the signs of addiction can be attributed to “growing old” (32.53 percent).

General aging is not always the explanation for certain mannerisms and changes in behavior. Sometimes an elderly person has suffered from chronic pain and relies on prescription opioids to relieve some of the pain. Consistently taking a drug such as oxycodone, hydrocodone, codeine, morphine and others can result in a dependence forming, which can lead to an addiction. Since many of the signs of a substance use disorder are viewed similarly to dementia or delirium, recognizing when an addiction is present in senior citizens can be challenging.

If you are a senior citizen or if you have an elderly loved one who is addicted to an opioid through a prescription, help is available. There are alternatives to medication for treating chronic pain, and The Recovery Village has a team of experts with the knowledge to help people remove opioids from their patients’ lives while also focusing on how to improve their quality of life. Call today to learn more about treatment plans and ways to help an elderly life feel young again.